Bill 179 Overview - Michele Acorn

179 Readiness SCOPE MSK Diagnostics Ajax May 14, 2010 Michelle Acorn President Elect NPAO NP PHC/Adult Lakeridge Health

1,656 NPs Today in Ontario College of Nurses of Ontario, April 30 2010 *6 members are certified in two specialties NP-Adult 295 NP-Paediatrics 126 NP-Primary Health Care 1,241 Total NPs 1,656*

National Perspective
All provinces and territories
Ontario has over 60% of all NPs in Canada
Total NPs in Canada: 2,250 (Fall 2009)
Most studied health professional in Ontario; provide safe and effective care!

Bill 179 System Impacts
Reflect current practice, education and competencies of NPs to enable full scope
Increase access to timely, safe, effective health care services
Increase efficiencies within the system and enhance cost effectiveness
Clarify and enhance accountability - self regulation

What is the status of the NP scope of practice review?
Regulated Health Professions Law Statute Amendment Act, 2009
On December 15, Ontario passed Bill 179 (Royal Assent).
The new Act amends 26 health-related statutes including the Nursing Act .
Although the bill has passed, the changes will not take effect until the College and the Ontario government amend regulations and set date(s) for proclamation.
The College will develop by-laws, update practice documents, and provide information to prepare nurses and other stakeholders for the changes. Consultations are underway.

Current NP Practice
Controlled Acts
Performing a procedure on tissue below the dermis or a mucous membrane
Putting an instrument, hand or finger into an opening of the body
Communicating a diagnosis
Prescribing a drug, or category of drugs, designated in the regulations
Administering a substance by injection or inhalation
Ordering the application of a form of energy prescribed in the regulations
Other Authorized Activities:
Ordering diagnostic tests
Ordering X-rays and mammography
Ordering laboratory tests

Coming
Controlled act of dispensing, selling, compounding
Controlled act of setting/casting of a bone or dislocation of a joint
Historic legislative and regulatory barriers that will removed and enable NPs to fully utilize their knowledge, skill and judgment include:
Applying a prescribed form of energy
Prescribing from a significantly broader range of drugs
Ordering a broader range of x-rays and CT
RNs/RPNs able to accept orders from NP to perform controlled act procedures: venipuncture.

CNO Additional Reque sts
Enable NPs to order diagnostics and treatments for hospital in-patients
Remove the restrictions on the lab tests and ultrasounds that NPs can order (eliminate the lists)
Permit NPs to perform point of care laboratory tests
Permit NPs to apply specified forms of energy (e.g., defibrillation)
Permit NPs to order MRIs, among other forms of energy
Access to oxygen, blood and blood products supported by CNO but not explicit in 179

Admitting, Treating, Discharge
Regulations under review by MOHLTC
Regulation 965 under the Public Hospital Act currently limiting scope and potential system impact, transfer of patients
Medical Advisory Council – Interprofessional shift
Enable RN(EC)s to provide health services to hospitalized in-patients (without directives)

Can NPs prescribe opiates?
The Controlled Drugs and Substances Act is federal legislation that governs the practice of prescribing controlled drugs in Canada.
Currently, NPs do not have the authority to prescribe opiates, including derivatives or synthetic formulations. Only the professions of medicine, dentistry or veterinary medicine can prescribe controlled substances.
In March 2004, Health Canada’s Drug Strategy and Controlled Substances Program announced plans to begin consultation on potential regulatory amendments that would expand prescriptive authority to other health professions, including NPs.
The College & NPAO has provided feedback on the proposed federal regulations that would permit NPs to prescribe controlled substances.
In March 2010, a new F/P/T working group has been established to review the regulation.

Bill 179 Readiness
Stakeholder partnering
NPAO SCOPE - CHE Working Group
Diagnostics– MSK pilot success!
Fitzgerald discount
Professional liability

Bill 179 Overview - Michele Acorn

by Nurse Practitioners' Association of Ontario on Aug 03, 2011

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Bill 179 Overview - Michele Acorn — Presentation Transcript